Mectizan delivery systems and cost recovery in the Central African Republic

Ann Trop Med Parasitol. 1998 Apr;92 Suppl 1:S97-100. doi: 10.1080/00034989859627.


The Central African Republic (CAR) has a serious onchocerciasis problem. The disease is endemic in three quarters of the country and there is considerable onchocercal blindness in the north-west. The low population density and extreme poverty (the CAR being one of the 20 poorest countries in the world) combine to make mass treatment with Mectizan (ivermectin, MSD) a challenge. Although planned, primary health care (PHC) is not widely developed in the country. Mectizan distribution was carried out in 1993-1994 by mobile teams in order to address the most urgent need, particularly in the north-west. Since then, the strategy has been one of community involvement, using village health workers, chosen by their own communities, to do the treatment. The system has been a stimulus to the development of PHC in some areas, as the co-ordinators of the Mectizan programme are often the only health personnel to visit every village. The long distances between health centres, with a mean of 45 km, are likely to be an obstacle to the population collecting their own Mectizan, within the self-treatment system otherwise in place. Operational research is planned to examine ways in which the population can contribute to cost recovery without there being a reduction in treatment coverage.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Central African Republic / epidemiology
  • Filaricides / economics
  • Filaricides / supply & distribution*
  • Health Care Costs
  • Health Expenditures
  • Health Services Needs and Demand / economics
  • Humans
  • Ivermectin / economics
  • Ivermectin / supply & distribution*
  • Onchocerciasis / drug therapy


  • Filaricides
  • Ivermectin